Describe your company's maintenance and inspection program that qualifies your vehicles to be used for the services provided. A copy of your formal inspection and maintenance written procedure manual would be helpful.*

Inspection and maintenance written procedure manual

Describe safety procedures in detail. If you have written policies and procedures, or an employee manual, please include a copy.*

Written policies and procedures, or employee manual.

Please describe the business's drug policy and what the procedure is when an applicant or employee fails a drug test:*

If you operate the taxi company with non-owned autos, describe in detail the inspection and auto maintenance safety program you have affected, to verify that all non-owned autos are provided the repair and maintenance service required for al autos operated under your name and/or permits.*

Do you have a written policy and procedure for handling customer complaints?*

Yes

No

If no, would you affect one and educate all company drivers of the company's program?*

Yes

No

Does the company have a fenced yard for auto storge?*

Yes

No

Please provide names and addresses of regulatory authorities requiring filings. Please include your filing number. Submit a copy of the current filings issued. If not issued, provide a copy of the application to be submitted.*

Copy of the current filings issued. (If not issued, provide a copy of the appllication to be submitted)*

Are drivers required to complete a signed and dated inspection report form, identifying the condition of the auto at the end of each shift during a 24-hour period?*

Yes

No

If yes, please provide a sample of the form used.*

If no, would you be willing to affect such a program?*

Yes

No

Does the company check references on driver applications?*

Yes

No

If no, would the company affect such a procedure as a provision to obtain the insurance?*

Yes

No

Are all autos you own which are operated as a taxi listed on the attached equipment form?*

Yes

No

If no, explain:*

The “Applicant” is the party to be named as the "Insured" in any insuring contract if issued. By signing this Application, the Applicant for insurance hereby represents and warrants that the information provided in the Application, together with all supplemental information and documents provided in conjunction with the Application, is true, correct, inclusive of all relevant and material information necessary for the Insurer to accurately and completely assess the Application, and is not misleading in any way. The Applicant further represents that the Applicant understands and agrees as follows: (i) the Insurer can and will rely upon the Application and supplemental information provided by the Applicant, and any other relevant information, to assess the Applicant’s request for insurance coverage and to quote and potentially bind, price, and provide coverage; (ii) the Application and all supplemental information and documents provided in conjunction with the Application are warranties that will become a part of any coverage contract that may be issued; (iii) the submission of an Application or the payment of any premium does not obligate the Insurer to quote, bind, or provide insurance coverage; and (iv) in the event the Applicant has or does provide any false, misleading, or incomplete information with the intent to deceive or materially affect the risk or hazard assumed by the Company in conjunction with the Application, any coverage provided will be deemed void from initial issuance.
The Applicant hereby authorizes the Insurer and its agents to gather any additional information the Insurer deems necessary to process the Application for quoting, binding, pricing, and providing insurance coverage including, but not limited to, gathering information from federal, state, and industry regulatory authorities, insurers, creditors, customers, financial institutions, and credit rating agencies. The Insurer has no obligation to gather any information nor verify any information received from the Applicant or any other person or entity. The Applicant expressly authorizes the release of information regarding the Applicant’s losses, financial information, or any regulatory compliance issues to this Insurer in conjunction with consideration of the Application.
In the event coverage is offered, such coverage will not become effective until the Insurer’s accounting office receives the required premium payment.
The Applicant agrees that the Insurer and any party from whom the Insurer may request information in conjunction with the Application may treat the Applicant’s facsimile signature on the Application as an original signature for all purposes.